doctors fleeing to Canada

[winterbadger]

from Migration Experts' Canadian Immigration News

Recent statistics released by the Canadian Institute for Health Information have suggested that there has been a significant increase of US physicians who have chosen to migrate to Canada from the US.

The data also suggests that there has been a decrease in the number of Canadian MDs choosing to migrate to the USA due to the introduction of President Obama's Health Care Reform Act.

In the past, many Canadian doctors chose to migrate to the USA due to the higher salary offered by the privatized health care system in contrast to the world renowned health care system Canada is known for. It seems, however, that the recently introduced heath reform within the US has prompted an exodus of US physicians into the northern border of Canada.

"Obama's health plan is caring the life out of all the doctors in the United States" stated CEO of CanAM Physician Recruiting in Halifax, John Philpott, "Talking to physicians in the United States, they're shocked at how much more money they can make in Canada".

Something make me think he meant "scaring", but I kind of like the mistake.

But...doctors are emigrating to *Canada* for better pay and to escape nationalised healthcare? That seems unlikely.

Looking at this summary of wages and this one confirm one's instinctive questioning of that idea.

But this article casts some doubt on the idea that doctors are always better paid in the US, by asking, "Yes, but what costs do they pay?" Higher gross salaries in the US may not account for the expense of administration, malpractice insurance, and the factor of constant academic versus fee for service income. Seemingly higher salaries in Canada, however, may not account for the difference in tax rates. All in all, an interesting question; I would if any medical journals or medical business journals have done a study?

Comments

[lotuslion.livejournal.com]

Another factor to consider regarding doctors' wages is the sheer amount of debt they incur in the US to become doctors. My friend just began a residency at Baylor Children's Hospital this year as a pediatrician; she makes $35K per year. When she finishes her residency (2 years) and enters a private practice, she can earn, on average, $200K per year, but she's $150K in debt from medical school alone (she has no undergraduate debt.) On a Frontline documentary, they interviewed doctors in Germany who make around $80K per year (USD), but they have far, far less debt because their educations are subsidized by the government. The trade-off is that in Germany, the state will only issue medical licenses in specialties of need, so if you really, really want to be a dermatologist, but the field is flooded with derms, you won't be able to enter that specialty. This "government interference" though prevents what we have in the US, which is an overabundance of specialists and not nearly enough primary care physicians, a gap that is only widening as doctors seek higher-paying specialty positions to mitigate their growing educational debts.

Also, if I were a doc, I think I'd move to Canada just to get away from dealing with the byzantine system of insurance coding and billing here in the US. My GI employs 2 staff people to deal exclusively with insurance companies: fighting over bills, getting prior authorizations, fighting denials of prior authorizations, etc etc.

On a somewhat related note, if you haven't yet, you should watch the Frontline pieces "Sick Around the World" and "Sick Around America." They're very interesting, and should be available free on PBS's website.

[winterbadger]

My GI employs 2 staff people to deal exclusively with insurance companies: fighting over bills, getting prior authorizations, fighting denials of prior authorizations, etc etc.

This is the thing that gets me: our supposedly "efficient" market-driven healthcare industry creates, as far as I can see, a lot of jobs that exist simply to argue about the value of a service. How much expense does the insurance industry go to (and rive medical practices to) in order to supposedly save money by quarreling over costs? If the whole game of "we'll pay this but not that, and we'll pay if you submit a claim this way but not if you submit the same claim that way" were axed and done away with, your GI could probably cut both those jobs and have the billing handled by the same person that bills patients. And the insurance company could probably cut hundreds of jobs!

Yes, that would mean lost jobs, but those are jobs that are creating NO VALUE to society or the economy. And it's jobs like that that make healthcare in the US so expensive and that are bidding fair to ruin our economy. IMO.

[lotuslion.livejournal.com]

I totally agree. I made that point to a kid in my medical policy class - all quarter he'd been raving on about government inefficiencies and bloat and waste and that handing healthcare over to the government would be a monumental disaster because of that. But when we pointed out all the inefficiencies and bloat and waste of the current medical system, he was like "Oh but we'll lose jobs!" and I responded, "Wait, so when the government is inefficient, that's bad and evil and we have to 'starve the beast,' but when the private sector is inefficient, we have to protect it for the sake of jobs? How's that work?" These free-market types are supposed to be ruthlessly practical and accept the losses of jobs in the name of efficiency and better service, so why is that not the case for the insurance industry?

Yeah, he had no answer. And it's disingenuous for folks to pretend that this is not part of what continues to drive up healthcare costs here.